Association between antibiotics use and diabetes incidence in a nationally representative retrospective cohort among Koreans

Park, Sun Jae; Park, Young Jun; Chang, Jooyoung; Choi, Seung Wook; Lee, Gyeongsil; Son, Joung Sik; Kim, Kyae Hyung; Oh, Yun Hwan; Park, Sang Min

doi:10.1038/s41598-021-01125-5

Cited by 18 publications

(11 citation statements)

References 39 publications

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“…CCI was calculated by the diagnoses for crucial comorbidities ( Sundararajan et al, 2004 ; Quan et al, 2005 ). Infectious diseases, which are possible comorbidities related to an antibiotic prescription, were included as covariates using the ICD-10 codes ( Park et al, 2021 ). Infectious diseases were adjusted for five sources of infection in the analysis model, not just one variable.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, we carried out sensitivity analyses that determined the association of antibiotic use with dementia risk after excluding patients diagnosed with dementia within the first 1–3 years of follow-up. In other words, we did not consider new cases of dementia for those diagnosed within the first 3 years of follow-up to address protopathic bias ( Park et al, 2021 ). We also conducted sensitivity analyses by shifting the index date to 1 year later to minimize possible confounding effects caused by the drug exposure period after the defined index date ( Kim et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

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Association between antibiotics and dementia risk: A retrospective cohort study

et al. 2022

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Background: The possible relation between antibiotic exposure and the alteration of gut microbiota, which may affect dementia risk, has been revealed. However, the association between antibiotics and dementia incidence has rarely been studied. We aimed to determine the association between antibiotic exposure and the risk of dementia.Methods: This population-based retrospective cohort study used data from the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in South Korea. Exposure was the cumulative days of antibiotic prescription from 2002 to 2005. Newly diagnosed overall dementia, Alzheimer’s disease (AD), and vascular dementia (VD) were identified based on diagnostic codes and prescriptions for dementia-related drugs. The follow-up investigation was carried out from 1 January 2006 to 31 December 2013. The Cox proportional hazards regression was used to assess the association between cumulative antibiotic prescription days and dementia incidence.Results: A total of 313,161 participants were analyzed in this study. Compared to antibiotic non-users, the participants who used antibiotics for 91 or more days had an increased risk of overall dementia [adjusted hazard ratio (aHR), 1.44; 95% confidence interval (CI), 1.19–1.74], AD (aHR, 1.46; 95% CI, 1.17–1.81), and VD (aHR, 1.38; 95% CI, 0.83–2.30). Those who used five or more antibiotic classes had higher risks of overall dementia (aHR, 1.28; 95% CI, 1.00–1.66) and AD (aHR, 1.34; 95% CI, 1.00–1.78) than antibiotic non-users.Conclusion: Antibiotic exposure may increase the risk of dementia in a cumulative duration-dependent manner among adult participants. Future studies are needed to assess the causality between the long-term prescription of antibiotics and dementia risk.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association between antibiotics and dementia risk: A retrospective cohort study

et al. 2022

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“…In the research, the non-users of antibiotics or the lowest users of antibiotics were used as reference groups. The group with the smallest number of antibiotic users was utilized as a reference when adjusting for indications of antibiotic use to reduce the possibility of multicollinearity [9].…”

Section: Key Variablesmentioning

confidence: 99%

“…The possibility of an association between antibiotic usage and various types of cancer, including prostate cancer, has been suggested in previous studies [6][7][8]. Previous cohort studies have reported that long-term antibiotic exposure may be associated with the risk of other diseases such as diabetes, dementia, and obesity [9][10][11]. The effects of antibiotics on gut microbiota diversity reduction and alteration have been revealed [12].…”

Section: Introductionmentioning

confidence: 99%

Association between Antibiotic Use and Subsequent Risk of Prostate Cancer: A Retrospective Cohort Study in South Korea

Park

Hong

Park

et al. 2023

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Background Several studies suggest that antibiotic use may affect overall cancer incidence, but the association between antibiotics and prostate cancer is still unclear. Methods A population-based retrospective cohort study was conducted using the Korean National Health Insurance Service (NHIS) database. 1,032,397 individuals were followed up from January 1, 2007, to December 31, 2019. Multivariate Cox hazards regression was utilized to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of prostate cancer according to accumulative days of antibiotic use and the number of antibiotic classes used. Results Individuals who used antibiotics for 180 or more days had a higher risk of prostate cancer (aHR, 1.46; 95% CI, 1.11-1.91) than those who did not use antibiotics. Also, individuals who used four or more kinds of antibiotics had a higher risk of prostate cancer (aHR, 1.18; 95% CI, 1.07-1.30) than antibiotic non-users. A similar trend was observed among participants who underwent health examinations. Conclusion Our findings suggest that long-term use of antibiotics may affect prostate cancer incidence. Further studies are needed to improve understanding of the association between antibiotic use and prostate cancer incidence.

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“…We considered covariates, including age, sex, residence, household income, smoking, alcohol consumption, physical activity, body mass index (BMI; kg/m 2 ), total cholesterol (mg/dL), systolic blood pressure (mmHg), fasting serum glucose (mg/dL), Charlson comorbidity index (CCI), the number of healthcare visit, and infectious diseases. To adjust the indication of antibiotic use, we included intra-abdominal infections; urinary tract infections; intestinal infectious diseases; skin, soft tissue, bone, and joint infections; and others (22) (Supplementary Table 2).…”

Section: Covariatesmentioning

confidence: 99%

Association between antibiotics and asthma risk among adults aged over 40: a nationally representative retrospective cohort study

Choi

Park

et al. 2022

Preprint

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Background Several previous studies reported that antibiotic exposure in early life could lead to asthma in early childhood. However, the association between antibiotic use and the risk of asthma in the adult population is yet unclear. Our study aims to investigate the association between antibiotic use and asthma in adults. Methods National Health Insurance Service-Health Screening Cohort data, which included 40 years or older aged subjects who have health screening examination data in 2005–2006, were used. Antibiotic exposure was examined from 2002 to 2006 and in total 256,698 participants with a mean age of 55.66 years were followed up from 2007 to 2019. During the follow-up period, 47,500 participants occurred asthma. To assess this association between antibiotic use and newly diagnosed asthma, the multivariable cox proportional hazards regression model was used. The considered covariates included residence status, body mass index, the number of healthcare visits, previous atopic dermatitis history, previous allergic rhinitis history, and infectious diseases. Results Participants with antibiotics use for ≥ 91 days showed a higher risk of asthma (adjusted hazard ratio [aHR] 1.88, 95% confidence interval [CI] 1.77-2.00), with a clear dose-dependent association (p for trend < 0.001). Furthermore, ≥ 4 antibiotic classes used group had an increased risk of asthma (aHR 1.67, 95% CI 1.58–1.76) than those who used only one antibiotic class. In our sensitivity analysis with wash-out period and shifting the index date, increased risk of asthma incidence and clear dose-response relationship according to antibiotics use have remained. Conclusions The clear dose-response pattern in antibiotics use and asthma may suggest that the management of proper antibiotic use in adults may lower the risk of asthma in the future.

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Association between antibiotics use and diabetes incidence in a nationally representative retrospective cohort among Koreans

Cited by 18 publications

References 39 publications

Association between antibiotics and dementia risk: A retrospective cohort study

Association between antibiotics and dementia risk: A retrospective cohort study

Association between Antibiotic Use and Subsequent Risk of Prostate Cancer: A Retrospective Cohort Study in South Korea

Association between antibiotics and asthma risk among adults aged over 40: a nationally representative retrospective cohort study

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